TWS Reports from the 77th World Health Assembly in Geneva, Switzerland

As the World Health Organization and other global bodies continue to deliberate and make decisions that affect people around the world, please join FRC in praying for the WHO with this special Prayer Guide.

Read FRC's public comment to HHS on the WHO pandemic agreement here.

12:38 p.m. EST, June 3, 2024

World Health Assembly Wraps Up by Passing New IHR But No Pandemic Agreement – For Now

The World Health Assembly proceeded into overtime on Saturday, as delegates sought last-minute agreement on the International Health Regulations (IHR) amendments and pandemic agreement, items that had preoccupied the meeting for the past several days.

Late in the evening of June 1, the assembly did pass amendments to the IHRs by consensus (meaning no nation objected to their passage) but failed to agree on text for a pandemic accord — something that occupied much of the focus of the WHO for the past several years. However, the assembly did authorize the Intergovernmental Negotiating Body (INB) tasked with developing a pandemic agreement draft to continue working toward one before the 2025 World Health Assembly, with the possibility that one might be agreed to by the end of 2024. The first virtual meeting of this group will be in July 2024.

Of the final IHR amendments passed Saturday night, many of the provisions that have drawn concern in recent months were in the final adopted version. The IHRs themselves have been in existence since 1969 and were last modified in 2005 but have drawn more attention in the years since the COVID-19 crisis, as government handling of the pandemic has become more closely scrutinized.

So what was added to the final version of the IHR passed on June 1? Here are some of the key changes:

• Definitions section: Adds a definition of “relevant health products,” which includes vaccines, medical products, and “technologies”
• Definitions section: Adds definitions for “pandemic emergency” and “national health authority”
• Article 2: Increases the scope of the IHR to “prepare for” diseases — something that had not been in the scope previously
• Article 3: The guiding principles were amended to include “equity and solidarity” (italicized text is new): “The implementation of these Regulations shall be with full respect for the dignity, human rights and fundamental freedoms of persons, and shall promote equity and solidarity.”
• Article 4: Requires a “national IHR authority” to be established or designated (with a directive to change a member state’s laws to accomplish this if needed). This authority will handle implementation of the IHR within the member state.
• Articles 8 and 10: Consulting with WHO changed from “may” to “should” (more of a requirement)
• Articles 11 and 12: Adds “pandemic emergency” (defined as discussed above) to the areas of public health concern that the WHO can respond to. These provisions grant more authority to the director general to make certain decisions, and in general, bind member states to a greater level of scrutiny and control.
• Article 13: WHO “shall work to facilitate” and provide “equitable” access to health products (defined as referenced above)
• Article 44: Requires that member states maintain or increase domestic funding to support implementing the IHR. Requires that states report on these outcomes at the next WHA.
• Article 44: Establishes a “coordinating funding mechanism” that will conduct analysis of where funding is needed and report to the WHA
• Article 54: A committee is established to “facilitate” the effective implementation of the IHR.
• Annex 1: One of the “core capacity” requirements under the new IHR is that countries build the capacity to address “misinformation and disinformation” — something that was not in the previous IHR.

In addition to the above sections, the concepts of “prevention” and “preparedness” have also been inserted into the new IHR. These are areas that the pandemic agreement (not the IHR) is designed to address. With their inclusion, we see the WHO’s desire to “integrate” the IHRs with any pandemic agreement that is developed — something that was discussed at the World Health Assembly. The WHO is definitely thinking of these two agreements as part of one package.

In addition, the IHRs contain a number of references to “experts” sitting on and advising panels and committees. Some of this language was in the previous IHR, but it is indicative of the type of approach these new IHRs are even more inclined toward than the previous: looking to experts, committees, and advisory panels for advice and guidance.

In summary, the new IHRs create a set of greater and more interlocking requirements than before, integrate a focus on COVID (or pandemics more broadly), require greater sharing of resources and technologies between countries, try to integrate national governments on their pandemic responses, and push for more funding.

Moving on from this year’s World Health Assembly, the focus will now turn to the next meeting of the INB regarding the pandemic agreement. The focus will also be on member states to see how and whether they implement these new IHRs. Under Articles 59 and 61 of the IHR, member states can object to new amendments or issue reservations, in which case those provisions will not enter into force with respect to the member state.

12:59 p.m. EST, May 31, 2024

Day 5: Report on the Current Status of Pandemic Agreement and IHR Amendments

Representatives of the working groups for the pandemic agreement and IHR amendments just updated delegates in Committee A on the progress of their ongoing discussions.

Representing the IHR amendment working group, Ashley Bloomfield reported that after meeting for the past two days, they are on “track for finalizing the package” and will bring it to Committee A for adoption soon. But, Bloomfield said, “we still have some work to finish,” and “as you all [can] imagine, because it’s toward the end of the process, it’s the final, few tricky issues.” Bloomfield was “confident” they will “have a package” ready to present to Committee A tomorrow after working to “finalize [the] resolution either tonight or tomorrow morning.”

Representing the INB (pandemic agreement) working group, Precious Matsoso reported that there was agreement on a portion of the text, but that “three other remaining paragraphs” are still in dispute. Further, whatever text is advanced to Committee A (and it’s likely that only fully agreed-to text will be advanced) would still need to be fashioned into a resolution, so their plan is to spend one hour tomorrow morning discussing final text and crafting it into a resolution, which will be presented to Committee A.

Presumably, some of the remaining points of disagreement include one or more of those previously identified this week:

• The definition of a pandemic emergency
• How to implement an equitable approach
• Technology transfer provisions
• How to finance the implementation

Any resolution that is presented tomorrow morning will have to make its way through the 77th World Health Assembly for approval in its waning hours; the assembly is scheduled to wrap by June 1.

References to sexual and reproductive health and rights at the World Health Assembly are pervasive, being included in speeches and official documents alike. Read more here about Finland’s remarks on this topic, as well as the assembly’s rejection of Taiwan’s request for observer status: Delegates Push for Abortion Expansion and Shun Taiwan at the World Health Assembly

7:50 p.m. EST, May 30, 2024

End of Day 4: Still No News on the IHR Amendments or Pandemic Agreement

Thursday ended with still no news from the “drafting group” that has been tasked here at the World Health Assembly with trying to generate a suggested way forward on the pandemic agreement and IHR amendments. The group met privately all day today. It’s possible that an announcement might come on Friday morning.

Meanwhile, member state delegates continued to posture and make their views known on this topic. This evening’s session of the Committee A meeting featured an agenda item reviewing implementation of the IHR, and several nations took the opportunity to opine on the current IHR amendment approval process. Germany said it wanted to finalize the amendments in this assembly and make them “future proof.” The United States said it “stands ready to adopt” the “targeted amendments” to the IHR.

Russia was less eager, however, and proceeded to argue a point about the implementation of the IHR being voluntary anyway (referencing past practice about implementation). Russia also said that the IHR must respect sovereignty. The need to respect sovereignty has been raised by some other countries as well over the past few days, and the skepticism and concern heard in such statements could be an indicator that there is more disagreement between member states than meets the eye (or has bubbled to the surface) on this topic.

In the meantime, we can assume that at least some of these previously-identified points of disagreement between member states remain:

• The definition of a pandemic emergency
• How to implement an equitable approach
• Technology transfer provisions
• How to finance the implementation

The IHR was not the only topic raised by delegates this evening. Belgium mentioned the need to attend to animal health, and that it was “concerned about limited access to sexual and reproductive health care services.” And Iceland was concerned about attempts to change language around “gender” (presumably in some WHO documents).

There is “no health without peace and no peace without health,” proclaimed another speaker before Committee A, once again bringing a focus on armed conflict into this week’s meetings, and providing yet one more example of the overly simplified, slogan-type claims often heard throughout the week here at the World Health Assembly.

FRC's Vice President for Policy and Government Affairs Travis Weber discusses the latest developments from Thursday at the 77th World Health Assembly in Geneva, Switzerland:

2:56 p.m. EST, May 30, 2024

Day 4: Member States Pledge Support to U.N. Sustainable Development Goal on Maternal Mortality — How Are They Talking about It?

As the fourth day of WHA77 kicked off, Committee A continued meeting to discuss items on its agenda — including one titled: “Acceleration towards the Sustainable Development Goal Targets for Maternal Health and Child Mortality.” This discussion related to how to achieve U.N. Sustainable Development Goal 3.1, which aims to reduce maternal mortality.

A lot of talk of “sexual” and “reproductive” health was presented throughout the discussion. Belarus discussed its work on sexual and reproductive health for teenagers, and the United Kingdom recognized the “vital importance” of “sexual health and rights.” A maternal mortality resolution co-sponsored by the United States with other countries was peppered with references to “sexual and reproductive health,” in addition to referencing universal health coverage.

An NGO statement led by Save the Children and joined by other NGOs, including International Planned Parenthood Federation, claimed that the world is far from achieving sexual health services and asked for a “rights-based sexual and reproductive health services” approach. They also asked for “disaggregation” of data by gender among other categories.

The United Nations Population Fund (UNFPA) talked about wanting to prevent unsafe abortion and see sexual health advanced.

Finally, several statements referred to “animal health,” with the U.K. requesting an “action-oriented political declaration aligned” with “One Health principles.” “Everyone and every animal … everywhere” should be able to access relief, the U.K. delegate said.

8:04 p.m. EST, May 29, 2024

End of Day 3: Status of IHRs and Pandemic Agreement; HHS Secretary Becerra Speaks in Geneva

As the third day of WHA77 finished, the closed-door drafting group meeting continued to hash out a possible way ahead on the pandemic agreement and IHR amendments. But we may see an announcement come out of that group soon, possibly tomorrow morning.

In a parliamentary briefing meeting near the end of the day, WHO official Dr. Jaouad Mahjour gave an update on the status of the IHR amendments — describing the major points of disagreement between WHO member states as being over:

• The definition of a pandemic emergency
• How to implement an equitable approach
• Technology transfer provisions
• How to finance the implementation

Giving an optimistic take on the situation, “hopefully by the end of the week,” he said, there could be agreement on the IHR amendments.

On the pandemic agreement (or status of the INB), he said that states differ on the timeline, with some wanting things done by the end of the year and others wanting to move it one to two years down the road.

Perhaps in a bid to get the IHR amendments across the line, U.S. Department of Health and Human Services Secretary Xavier Becerra was in Geneva today delivering remarks at WHA77, where he expressed a desire to see approval of the IHR amendments soon.

In his speech, Becerra also — like virtually every other U.S. government official at WHA77 over the last few days — insisted on making a point about U.S. foreign policy on sexuality. “We must recognize (1) the value of a world that is equitable and inclusive; (2) the necessity of advancing sexual and reproductive health and rights for all; and (3) the importance of including the voices of women, minorities, and LGBTQIA+ populations into decision-making.”

Some of his wording was almost identical to the language on sexuality used by other U.S. representatives speaking at WHA77.

Becerra also initially uttered “Palestine” when referring to the conflict between “Israel and Palestine,” and had to be corrected after the fact, with the version of his speech posted online by the U.S. Mission in Geneva reading “Israelis and Palestinians.”

Israel has been criticized constantly at WHA77 — often based on the claim that it is disrupting health and health care with its operation within Gaza, but some member states have seen fit to openly and clearly criticize Israel without even linking their criticism to health. At WHA77, countries operating in other conflict zones around the world have not been proportionately criticized.

With Becerra’s speech, the Biden administration seems to be kicking its focus on the IHR amendments into high gear, while putting the pandemic agreement on low burn. The IHR amendments have been mentioned by other U.S. officials in their public remarks at WHA77, and the United States is helping lead a resolution on the topic.

FRC's Vice President for Policy and Government Affairs Travis Weber discusses developments from day 3 of the 77th World Health Assembly in Geneva, Switzerland, where HHS Secretary Xavier Becerra spoke, among others.

10:49 a.m. EST, May 29, 2024

Delegates Affirm WHO Priority of Universal Health Coverage — but What Does That Mean?

As Committee A convened again this morning, member states gave speeches on the first topic on the agenda — universal health coverage (UHC). This is one of the “triple billion” target priorities of the WHO; in this case, the WHO is aiming for “one billion more people benefitting from universal health coverage.” The goal is part of the U.N.’s Sustainable Development Goal 3.8, which global institutions are working to meet by 2030.

However, the question is: What is included in the definition and meaning of “universal health coverage”? And what values are they drawing upon to inform this definition?

For its part on this topic, Norway made sure to highlight sexual and reproductive health (SRH). Germany’s delegate said “sexual and reproductive health” is an “essential part of UHC.” She also highlighted “gender responsive” approaches. The United States proclaimed support for universal health coverage and focused on “LGBTQI+ persons” in its comments.

Canada’s delegate mentioned reproductive health, universal health coverage, and global health security all in one speech, conceptually linking the three. Global health security has also been a topic of recent focus from the U.S. government; in April 2024, the Biden administration released its Global Health Security Strategy. This follows the administration’s launch in August 2023 of a new Bureau of Global Health Security and Diplomacy, run out of the U.S. State Department by Dr. John Nkengasong, who was appointed by Biden to manage the President’s Emergency Plan for Aids Relief (PEPFAR). Under the Biden administration, PEPFAR has disbursed at least $1.34 billion of U.S. tax dollars to pro-abortion groups.

It might be expected that the above countries and others will view the definition of UHC to include their priorities on sexual and reproductive health. And if security concerns are linked to health concerns, attaining this definition of UHC could eventually become an issue of national and international security.

10:40 a.m. EST, May 29, 2024

Drafting Group Begins Trying to Find a Solution on Pandemic Agreement and IHR Amendments

At its conclusion last evening, Committee A announced (in light of “strong support” for the proposal) the creation of a “drafting group” to continue work on agenda item 13.3 (IHR amendments) and 13.4 (pandemic agreement). The presiding officer of Committee A announced that the drafting group would be open to all member states, as well as all members of the drafting group of the INB and the working group of the IHR.

The drafting group convened at 9:30 a.m. (CEST) this morning and will continue working into this afternoon.

Three different resolutions are currently circulating at WHA77 on these topics, with two on the INB/pandemic agreement, and one on the IHR:

• The 47 African nations have proposed a resolution calling for a final pandemic agreement to be considered by a special session of the WHA before the end of 2024.
• Australia, Brunei, Canada, Norway, and Pakistan have proposed a resolution with a similar timetable but have proposed optional language that could extend it beyond 2024.
• France, Indonesia, Kenya, New Zealand, Saudi Arabia, and the U.S. have proposed a resolution focusing on approval of the amendments to the IHR.

It is expected that the pandemic agreement and IHR amendments will be part of the same discussion in the drafting group today. Tuesday, in the Committee A meeting, several nations stressed the need to consider how they fit together in a complementary way.

Tuesday night, FRC's Vice President for Policy and Government Affairs Travis Weber, joined "Washington Watch" from the 77th World Health Assembly in Geneva, Switzerland, as the effort continues to block the World Health Organization’s proposed pandemic treaty.

8:36 p.m. EST, May 28, 2024

WHA77 Day 2: WHO Member States Discuss Way Forward for Pandemic Treaty and IHR Amendments

This afternoon, in the Committee A meeting, member states convened to discuss the future of the Intergovernmental Negotiating Body (INB) and the pandemic agreement, along with amendments to the International Health Regulations (IHR). While there were some exceptions, delegates overwhelmingly urged continued support for the INB process and IHRs. The main point of disagreement between member states was the precise process and timeline for each.

A few, like Ireland, offered an aggressive timeline and expressed hope that amendments to the IHRs could be approved this week. Israel stated the same. Interestingly, the Jewish state said there may be IHR consensus by the end of the week but recognized we “are not doing enough public diplomacy” on the IHRs and pandemic agreement and acknowledged a need to share more with the public and be more transparent. Israel also identified three principles it would be guided by: (1) state authority over health within borders (which sounds a bit like a concern for sovereignty), (2) a need for clarity on areas related to technology rights, and (3) a need for clarity that existing funding would be used instead of new funding.

The United States also pushed for finalization of the IHR amendments by the close of this week and may endeavor to rally other countries in support of that effort.

Even so, most delegates recognized that completing a pandemic agreement or amendments to the IHRs by May 2024 was going to be a tight timeline and that more time would be needed. Some expressed a desire to aim for the end of 2024, and others expressed the need for more time without naming a deadline. For instance, Switzerland said “we must not rush” but rather “take the time we need” for success — without saying how much time that would be. Poland likewise didn’t name a timeline. Canada said it’s important to prioritize “realizing human rights” and “advancing gender equity” and observed that “health equity” should be promoted throughout the pandemic cycle. “Canada is looking to an overall consensus text that the majority of member states can … ratify and implement. This should not be rushed,” its delegate said.

A non-government organization (NGO) called Global Health Council submitted a statement very supportive of the pandemic agreement and IHRs on behalf of a number of other NGOs, claiming any pandemic agreement should be complementary with the IHRs and include civil society and ensure “gender parity.” Financing for pathogen access and benefit sharing (PABS) — a major sticking point of the pandemic agreement negotiations — is needed for low- and middle-income countries, they said.

Some countries expressed general support for the pandemic agreement and IHR process but also expressed their concern that any such agreement should respect national sovereignty. The United Kingdom seemed to throw some cold water on the idea of the pandemic agreement being reached quickly and noted that it supports this process but that the agreement “should fully respect national sovereignty.” Jamaica, among other concerns, also wants the pandemic agreement to respect national sovereignty. Jamaica also asked for a minimum one-year extension to resolve all outstanding issues.

Yet not all countries in Committee A went along so willingly. Argentina cast doubt on the pandemic agreement being the right approach to our challenges, observing that the current process is “not necessarily the way to solve the problems” that we might come up against in a future pandemic. Paraguay criticized the process in which this has been undertaken, pointing out that a draft was delivered for review within a week of this week’s gathering and did not allow enough time for proper review. Paraguay said we need “at least another year” to analyze the complexity around this topic and respect the domestic processes of each member state.

As of now, it appears that member states will continue to work through the close of WHA77 on June 1, aiming to finalize the package of amendments to the IHR (2005) and agree on the timing, format, and process to conclude the pandemic agreement.

5:07 p.m. EST, May 28, 2024

Member States Balk at Infringement on their Cultural Values

Amidst ongoing negotiations at the 77th World Health Assembly over different resolutions, some member states are raising objections to the inclusion of language commonly seen as an affront to their social and cultural values. While the question of Western countries advancing social policies around the world that are at odds with the (often) poorer nations where they are being pushed is not new, it appears to have taken WHO member states off-guard in these current negotiations.

Today, Health Policy Watch reports:

“Conservative countries have objected to the use of the terms ‘gender responsive’ and ‘advancing gender mainstreaming’ in behind-the-scenes negotiations on several resolutions before the World Health Assembly (WHA), according to a wide variety of sources.

“There have also been some objections to the use of ‘gender equality’ and ‘sexual’ in some instances — alongside a long-standing objection to the use of ‘rights’ when referring to sexual and reproductive health.”

The issue goes back further than the past few days of negotiating resolutions at WHA77:

“‘Gender’ references have already been stripped from the World Health Organization’s (WHO) draft pandemic agreement. At least five other resolutions have become bogged down by objectives from conservative member states, particularly Russia, Egypt, Iran and Nigeria.

“These include resolutions on mental health, emergency preparedness, the economics of health, climate and social participation.

“In the case of the economics of health resolution, Nigeria initially objected to the use of both ‘gender equality’ and ‘advancing gender mainstreaming,’ one source said.

“Another source told Health Policy Watch that Russia even wants ‘sexual’ to be removed from the standard term, ‘sexual and reproductive health.’

“In the resolution on climate and health, for example, there was an impasse over the use of ‘gender-responsive’ policies — apparently because conservatives believe that this opens the door to engagement with LGBTQ groups although they have never unpacked their objection. Countries have eventually settled on a reference to ‘gender equality.’”

The objections of conservative member states have left some arguing “Well, you didn’t say anything before”:

“Objecting to these particular phrases is new. All UN member states including Russia agreed by consensus to the language of the global Sustainable Development Goals (SDGs), which refer to sexual health and gender.”

While a fair point, it is not to be overcome that the member states are objecting now.

This development is concerning enough for proponents of this sexuality language to need to point to their group of “experts” in support of it:

“A few days ago, 43 of the foremost global experts in sexual and reproductive health and rights (SRHR) in the UN called on the WHA to protect advance in this hard-won space in an article published by Health Policy Watch.

“The experts, who work in various UN expert committees, described progress on SRHR as ‘fundamental for human rights and dignity, national economies, sustainable development, and a healthier planet.’ 

They added that while SRHR includes ‘services needed to prevent unwanted pregnancies, unsafe births and avoidable sexual or reproductive illness, injury or dysfunction,’ it is much broader. 

“‘Vitally, it includes the positive enjoyment of consensual sexual intimacy and pleasure, the development of mutually respectful and loving relationships, as well as the affirmation of individuals and families in all their diversity,’ they added.”

That last line is certainly to be disputed by many around the world, if only those negotiating these WHO resolutions would ask. If they do, they might hear and learn from a different perspective they never would have known about otherwise.

11:45 a.m. EST, May 28, 2024

WHA77 Day 2: Israel, Climate Change, Pandemic Agreement Push, and Sexual and Reproductive Health

• Israel and U.S. delegates also speak
• Azerbaijan’s comments on Nagorno-Karabakh not challenged by any member state

The morning plenary session (the “main stage” of the World Health Assembly) wrapped up after several hours of short speeches from delegates representing their home countries. Amid general comments on the importance of focusing on health care and affirmation of the WHO, certain themes emerged from this morning’s series of speeches.

Countries continued to pressure and single out Israel for criticism at the WHA77 proceedings. Some delegates mentioned the Jewish state specifically, while others just mentioned Gaza or Palestine in their comments, with the implication that the WHO and world community should act immediately to stop Israel’s operations in Gaza. The Malaysian representative referred to “Israeli aggression” (referring to the COVID-19 pandemic in his next breath as one of humanity’s “greatest moral failures”). Meanwhile, Gaza and/or “Palestine” were mentioned by Colombia, Ireland, Slovenia, Morocco, New Zealand, and Tunisia, who referred to people in Gaza being “targeted in unprecedented vicious campaign by [the] occupiers.”

Colombia, ironically, said it “puts life before everything” in this context (despite its shift toward more liberal abortion laws). Most of these references to Gaza made little to no reference to health care actually being undertaken (or not undertaken) within Gaza, and no delegate made reference to actions by the Hamas governing authorities which have inhibited the provision of health care within Gaza.

Yet Israel, when it addressed the assembly today, focused on what its nation’s health care system did in the context of this conflict to care for their wounded and dead when Hamas attacked on October 7. Israel also acknowledged the pain and suffering in Gaza but observed that the brutal Hamas leadership puts civilians in harm’s way (this is a direct contrast to the steady stream of delegate comments on Gaza over the past few days which have overwhelmingly failed to recognize the Israeli dead or wounded while commenting on the ongoing war). Even as a party to the conflict, Israel’s delegate is the only one so far as WHA77 to have noticeably recognized the pain and suffering on both sides.

Even the United States couldn’t refrain from pressuring Israel, referring to the need for a ceasefire and a “two-state solution” (without connecting that reference to health or health care). The United States also failed to defend its ally Israel against the steady stream of pressure Israel has been under at the assembly for the past several days.

The United States also pushed hard for a sexuality agenda, recognizing the “value” of an “inclusive” approach, and noting the necessity of advancing “sexual and reproductive health,” and of bringing “LGBTQI+ populations into decision-making.” President Biden is “fully committed” to the WHO, the U.S. delegate said, observing there is no “stability” or “security” without health.

The elevation of sexuality language wasn’t limited to the United States. Western Europe and Anglosphere countries have highlighted this priority of theirs in the past few days, with Denmark, Norway, and New Zealand all discussing it in one form or another this morning. Norway mentioned sexual and reproductive health, and New Zealand focused on sexual orientation and gender identity. Denmark’s delegate conducted an extended monologue that appeared to celebrate how his country was pushing for more legalized abortion with fewer limits for young people, discussing how we need to look to the views of young people to determine the right policies.

Continuing a theme from the first day, climate change continued to be mentioned as a threat, with Azerbaijan (discussing at length what it was doing to create a “green” society), Ecuador, Fiji, and New Zealand including it in their comments addressing the morning plenary session.

Notably, Azerbaijan also discussed its efforts regarding the “return of formerly displaced persons” to the “devastated, liberated territories” and “formerly occupied lands” — almost certainly a reference to the Nagorno-Karabakh area, from which Azerbaijan recently drove out thousands of ethnic Armenians in a war of aggression launched in the last several years with the cooperation of Turkey. No member state delegation at the WHA77 has so far commented on Azerbaijan’s actions in this regard, despite an overwhelming focus on other conflicts like the one in Israel.

Delegates also continued to highlight the need for a pandemic agreement, the Intergovernmental Negotiating Body (INB), and/or the International Health Regulations (IHRs). Tunisia (“none of us is safe unless everyone is safe”), Bolivia, Morocco, Israel, and the United States all commented positively in this regard.

Some may ask why matters like armed conflict are being discussed at all at an assembly that is supposed to be focused on health. It’s a good question. The World Health Assembly agenda should in theory be connected to health; at one point early in the plenary today, Russia objected to comments by Japan (criticizing its conduct in Ukraine) that were not on the agenda. The presiding officer then asked the Japanese delegate to stick to the agenda. Even when addressing disparate matters, delegates will often at least try to link the content of their speeches to health. The incessant pressure and targeting of Israel, however, seems to at times reveal exceptions to this rule.

9:21 a.m. EST, May 28, 2024

WHA77 Day 1

The 77th World Health Assembly (WHA77) opened Monday, May 27 in Geneva, Switzerland, with introductions and welcome messages from world leaders and global officials. The WHA77 theme of “all for health, health for all” was prominently featured.

Thomas Bach, president of the International Olympic Committee, remarked on the importance of the World Health Organization (WHO) to upcoming Olympic events, proposing a slogan “All for health, health for all, sport for all.” He was followed by U.N. Secretary General Antonio Guterres, who gave a video address in which he referred to the Pandemic Preparedness Agreement (the topic of much recent contention and debate) as a “once in a lifetime opportunity,” and also encouraging support for recent International Health Regulations amendments (which have received less attention but have still been cause for concern). Guterres’s remarks will add pressure to advance both measures.

Next, Ursula von der Leyen, president of the European Commission, stated she would be a “strong ally” to the WHO and claimed, “Let us be all for health, to deliver health for all.”

Closing the first plenary session was Dr. Tedros Ghebreyesus, director-general of the WHO, who referenced “outbreaks, disasters, conflicts, and climate change” as challenges to be addressed. Working on health in any country “benefits all countries,” he suggested. Mentioning the U.N.’s 2030 Sustainable Development Goals, he pushed for more WHO funding (the WHO has launched an “Investment Round” request for $7 billion in funding for the next four years). Tedros closed by encouraging a path forward on the Internation Health Regulation (IHR) amendments.

Opening Day Afternoon Plenary Session — Highlights from Remarks by Tedros Ghebreyesus

Near the beginning of the WHA77 first day’s afternoon plenary session, Ghebreyesus reviewed the WHO’s work from the last year. Of interest, he referenced the “physical, mental and social” aspects of health, but not the spiritual aspects. He reflected negatively on “disruptions” to routine immunization programs in a number of countries (pertaining to yellow fever, polio, and other such ailments), in an implicit acknowledgment of the effect of the COVID-19 lockdowns. He also highlighted the WHO’s work on “sexual and reproductive health,” and closed by encouraging nations to “work together for a healthier, safer, fairer world.” Notably absent from this close was any mention of “freedom.”

Opening Day Afternoon Plenary Session Features Themes of Universal Health Coverage, Climate Change, and a Focus on Israel

The following themes featured prominently in delegate remarks as the WHA77 concluded its first day of activity here in Geneva.

• Universal health coverage (multiple delegates repeated “all for health, health for all”)
• Climate change as a major crisis negatively affecting our health
• Pressure to get a pandemic agreement done (now or in the future)
• Focused condemnation of Israel’s war in Gaza, and with somewhat less (though still noticeable) condemnation of Russia’s war in Ukraine
• Discussion of needing to fund the WHO

Other themes and points of discussion included:

• “Equity” as a priority in health care
• The One Health concept
• Whether Taiwan would be given observer status to the WHO (this was rejected)
• Sexual and reproductive health as a topic of focus
• Mental health as a topic of focus

In several notable remarks, the EU representative referenced the “root causes of health,” such as “climate change.” The representative of Papua New Guinea said that “climate change is the biggest health threat of the 21st century.”

The Cape Verde representative, speaking on behalf of Portuguese-speaking countries, referenced the “primary purpose of government” was to work on health.

The Netherlands representative, aligning itself with the anti-Israel statement delivered previously, focused on sexual and reproductive health and climate change. These are “global health priorities” — sexual and reproductive health, climate change, and universal health coverage, she said. Proceeding past her allotted time, she said “access to health care needs to be universal.”

Israel was also the target of many countries this afternoon, with multiple Western and non-Western country delegates criticizing its ongoing operations in Gaza.

The conflict between Russia and Ukraine also featured in delegates’ remarks, with multiple countries expressing support for Ukraine, whose representative received extended applause after concluding his remarks.

The U.K. expressed support for the pandemic accord and IHRs, emphasizing the “all for health, health for all” theme. He focused on “digitizing access” and harnessing the power of artificial intelligence, and welcomed the “climate and health” focus — “climate change poses a serious threat to health systems around the world,” he said. The U.K. also highlighted how their national health service cut its “carbon footprint.”

Germany pressured Israel over its operations in Gaza and focused on climate change as well.

Brazil’s delegate referenced a “climate social and health emergency.” Climate change must be at the heart of the new health agenda, they said. Brazil is also moving toward universal health access.

Near the end of the day, Australia’s remarks focused on Gaza and called for a ceasefire, noting the number of deaths including children. Health must be available regardless of “gender, age, sexual orientation, or religious beliefs” its representative said, adding that it must be disability and sexuality inclusive. The Australian delegate closed by focusing on the “decarbonization of health systems.”